Verify Eligibility Electronically As Needed

Practices that subscribe to NextGen Healthcare's Electronic Data Interchange® (EDI) service can check eligibility electronically on an as-needed basis. An insurance eligibility report details the response from the carrier. 

Note: Insurance last verified dates displaying in red indicate it has been more than 30 days since an eligibility verification was performed.

1. On the Patient Overview window, click the eligibility icon (either Verified or Needs verification ) in the Dental Insurance section.

   

   The Patient Eligibility window displays.

   

2. Select Primary or Secondary or both to indicate which coverage will be checked. The far-right column of the Current Insurance Policies section indicates whether the plan is eligible for a real-time eligibility check.

   Note: To view details about a patient's primary or secondary insurance plan, click the plan ID.

3. Click Check Eligibility.

   The system submits a request for an eligibility check and logs the request in the history in the lower half of the window. When a response is received from EDI, the result will appear in the history, and you will be able to view and print the eligibility report by clicking the link in the Report column. If applicable, the patient's status will also change to verified.